Search Results (3,028)

Incidental capture (bycatch) is a major threat to all seven marine turtle species worldwide. This systematic review assessed (i) research trends over the past 20 years; (ii) relationships between fishery types, gear, and species caught; (iii) post-capture outcomes; and (iv) challenges in bycatch mitigation. A systematic search of Web of Science and Scopus up to April 2024 identified 236 studies, comprising 336,616 global bycatch records. Publications on turtle bycatch increased significantly (p < 0.001), peaking in 2020. Reported captures also rose (ρ = 0.45; p = 0.026), with Caretta caretta most frequently documented (74.8%). Methodology influenced outcomes: aerial monitoring and direct observation underestimated captures of Chelonia mydas, Lepidochelys kempii, and Eretmochelys imbricata compared with mixed methods; interviews only affected the latter. Regarding fishery interactions, Dermochelys coriacea was more susceptible to hook-and-line fishing (p = 0.0079), while C. mydas was more associated with small-scale fisheries (p = 0.0115). Most turtles were released after capture (60.6%), with no significant temporal variation in outcomes (p > 0.05). Despite growing monitoring, knowledge gaps remain in standardized reporting, regional and species coverage, and methodological integration. Addressing these issues is essential to guide effective, collaborative conservation strategies. Full article

Between 2018 and 2025, alternative finance expanded while micro-, small- and medium-sized enterprises in emerging economies continued to face a substantial funding gap. This study examines how entrepreneurial frugality articulates frugal ecosystems, access to alternative finance, resilience and SME performance within a single explanatory framework. Following PRISMA 2020 and PRISMA-S, we conduct a systematic review of Scopus, Web of Science and Cairn; out of 1483 records, 106 peer-reviewed studies are retained and assessed using the Mixed Methods Appraisal Tool and a narrative synthesis approach. The findings show that frugal ecosystems characterized by pooled assets, norms of repair and modularity, and lightweight digital tools reduce experimentation costs and develop frugal innovation as an organizational capability. This capability enhances access to alternative finance by generating readable quality signals, while non-bank channels provide a financial buffer that aligns liquidity with operating cycles and strengthens entrepreneurial resilience. The article proposes an operationalized conceptual model, measurement guidelines for future quantitative surveys, and public policy and managerial implications to support frugal and inclusive innovation trajectories in emerging contexts. Full article

Background/Objectives: Uremic pruritus is a common complication in patients with end-stage kidney disease undergoing maintenance hemodialysis. Despite its high prevalence and substantial impact on sleep, psychological well-being, and overall quality of life, its pathophysiology remains multifactorial and incompletely understood. This narrative review summarizes contemporary evidence (2015–2025) on therapeutic strategies for uremic pruritus, with an emphasis on emerging treatments and evolving mechanistic insights. Methods: A PubMed search was conducted for original clinical studies published between 1 January 2015, and 31 October 2025, evaluating treatments for uremic pruritus in adult hemodialysis patients. Eligible study designs included randomized controlled trials and observational interventional studies. Non-English articles, pediatric studies, peritoneal dialysis studies, reviews, case reports, and studies of mixed-etiology pruritus were excluded. Earlier literature was reviewed to contextualize epidemiology and pathophysiology. Results: The review identifies multiple interacting mechanisms—including uremic toxins, immune dysregulation, mineral abnormalities, xerosis, neuropathic changes, and dysregulated opioid signaling—contributing to itch generation. Topical therapies, especially emollients and humectants, consistently improved symptoms with excellent safety profiles. Optimization of dialysis adequacy and membrane selection showed benefit in selected patients. Among systemic therapies, gabapentinoids demonstrated the most robust efficacy but required cautious dosing. Sertraline, nalbuphine, and difelikefalin showed significant antipruritic effects in controlled trials. Emerging therapies, including AST-120, omega-3 fatty acids, and the biologic dupilumab, demonstrated promising but preliminary results. Conclusions: Management of uremic pruritus requires a multifaceted, individualized approach integrating skin-directed therapies, dialysis optimization, and targeted systemic treatments. Ongoing research is needed to identify reliable biomarkers and to develop safer, more effective, mechanism-based therapies. Full article

Background: Pancreatic cancer is the least survivable malignancy, with five-year survival below 10%. Its vague, non-specific symptoms contribute to late diagnosis and poor outcomes. Targeted education for healthcare professionals, students, patients, carers, and the public may improve awareness, confidence, and early help-seeking. This scoping review aimed to map and synthesize peer-reviewed evidence on pancreatic cancer education, identifying intervention types, outcomes, and gaps in knowledge. Methods: A scoping review was undertaken using the Joanna Briggs Institute (JBI) framework and the Arksey and O’Malley framework and reported in accordance with PRISMA-ScR guidelines. The protocol was registered on the Open Science Framework. Four databases (MEDLINE, Embase, CINAHL, PsycINFO) were searched for English-language, peer-reviewed studies evaluating educational interventions on pancreatic cancer for healthcare students, professionals, patients, carers, or the public. Grey literature was excluded to maintain a consistent methodological standard. Data were charted and synthesised narratively. Results: Nine studies (2018–2024) met inclusion criteria, predominantly from high-income countries. Interventions targeted students and professionals (n = 3), patients (n = 2), the public (n = 2), or mixed groups (n = 2), using modalities such as team-based learning, workshops, virtual reality, serious games, and digital animations. Four interrelated themes were identified, encompassing (1) Self-efficacy; (2) Knowledge; (3) Behavior; and (4) Acceptability. Digital and interactive approaches demonstrated particularly strong engagement and learning gains. Conclusions: Pancreatic cancer education shows clear potential to enhance knowledge, confidence, and engagement across diverse audiences. Digital platforms offer scalable opportunities but require quality assurance and long-term evaluation to sustain impact. The evidence base remains limited and fragmented, highlighting the need for validated outcome measures, longitudinal research, and greater international representation to support the integration of education into a global pancreatic cancer control strategy. Future studies should also evaluate how educational interventions influence clinical practice and real-world help-seeking behaviour. Full article

Background: Minimally invasive pancreatoduodenectomy (MIPD) has evolved from an experimental technique to a feasible surgical option for pancreatic cancer in selected settings. However, its oncologic adequacy, safety, and generalizability remain debated, particularly given the biological aggressiveness of pancreatic ductal adenocarcinoma (PDAC) and the technical complexity of the procedure. Methods: This narrative review critically summarizes contemporary evidence regarding MIPD for pancreatic cancer, with particular attention to randomized controlled trials (RCTs), meta-analyses, and large observational studies. We distinguish findings derived from mixed periampullary tumor cohorts from those specific to PDAC and evaluate methodological limitations, learning-curve effects, and sources of heterogeneity across studies. Results: Recent RCTs and meta-analyses demonstrate that, when performed by experienced surgeons in high-volume centers, MIPD achieves perioperative outcomes comparable to open pancreatoduodenectomy, with advantages including reduced blood loss, shorter hospital stay, and faster functional recovery. Importantly, oncologic parameters such as R0 resection rates and lymph node yield appear equivalent between approaches, although robust long-term survival data from PDAC-specific RCTs remain lacking. Emerging evidence supports the feasibility of MIPD in complex clinical scenarios, including after neoadjuvant therapy, in frail or elderly patients, and in selected cases requiring vascular resection. Nonetheless, outcomes are strongly influenced by surgeon experience, institutional volume, and patient selection. Cost-effectiveness analyses and data from lower-volume centers remain limited. Conclusions: Current evidence supports MIPD as a viable alternative to open surgery for pancreatic cancer in carefully selected patients treated at specialized centers. However, claims of oncologic superiority are premature. Future research should focus on PDAC-specific randomized trials, standardized quality metrics, and strategies to mitigate learning-curve and resource-related barriers to broader implementation. Full article

The rapid advancement of energy collection and storage systems (ECSSs) is fundamentally reshaping global energy markets and accelerating the transition toward low-carbon energy systems. This study provides a comprehensive assessment of the economic benefits and systemic effects of advanced ECSS technologies, including photovoltaic-thermal (PV/T) hybrid systems, advanced batteries, hydrogen-based storage, and thermal energy storage (TES). Through a mixed-methods approach combining techno-economic analysis, macroeconomic modeling, and policy review, we evaluate the cost trajectories, performance indicators, and deployment impacts of these technologies across major economies. The paper also introduces a novel economic-mathematical model to quantify the long-term macroeconomic benefits of large-scale ECSS deployment, including GDP growth, job creation, and import substitution effects. Our results indicate significant cost reductions for ECSS by 2050, with battery storage costs projected to fall below USD 50 per kilowatt-hour (kWh) and green hydrogen production reaching as low as USD 1.2 per kilogram. Large-scale ECSS deployment was found to reduce electricity costs by up to 12%, lower fossil fuel imports by up to 25%, and generate substantial GDP growth and job creation, particularly in regions with supportive policy frameworks. Comparative cross-country analysis highlighted regional differences in economic effects, with the European Union, China, and the United States demonstrating the highest economic gains from ECSS adoption. The study also identified key challenges, including high capital costs, material supply risks, and regulatory barriers, emphasizing the need for integrated policies to accelerate ECSS deployment. These findings provide valuable insights for policymakers, industry stakeholders, and researchers aiming to design effective strategies for enhancing energy security, economic resilience, and environmental sustainability through advanced energy storage technologies. Full article

Research suggests that older adults might obtain health benefits from pet ownership; however, results are mixed. Pet attachment is suggested as both a mechanism for the relationship and a reason for differences in the association of pet ownership with health outcomes. This systematic review examines evidence for the relationship between pet attachment and health outcomes among older adults. The Open Science Foundation-registered review began with 20,795 candidate articles. We limited our review to the 58 articles that consisted of original research, published in peer-reviewed journals between 1965 and June 2025, written in English, included older adults (age ≥ 50 years) or were limited to only older adults, and examined the relationship between pet attachment and health outcomes. The articles included analyses of psychological (n = 53), social (n = 27), or physical (n = 2) health outcomes. Pet attachment was assessed with 19 tools; most frequently the Lexington Attachment to Pets Scale (n = 21) and the Pet Attachment Questionnaire (n = 8). The studies were not consistently of high quality according to OCEBM criteria. Except for grief, which was consistently related to pet attachment, the findings do not support a clear relationship between pet attachment and health outcomes in older adults. Findings suggest that the relationship between pet attachment and health outcomes may be more pronounced in younger than in older adults. Full article

Background/Objectives: Palliative care education is a core component of undergraduate nursing preparation; however, many nursing students report limited exposure and confidence in providing end-of-life care. Digital and web-based educational approaches have increasingly been adopted to address gaps in palliative care training and to provide flexible, scalable learning opportunities. This mixed-methods systematic review examined the use of digital and web-based approaches in palliative care education for pre-registration nursing students. The aim was to synthesize existing evidence on educational outcomes, confidence development, practice preparation, and acceptability to guide future design and implementation of technology-enhanced learning in this field. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. The search was conducted across Medline (Ovid), Embase, CINAHL, Scopus and PsycINFO in October 2025. Studies employing qualitative, quantitative, or mixed-methods designs were eligible if they evaluated fully digital or web-based palliative care educational interventions for nursing students. Screening, quality appraisal, and data extraction were undertaken independently by multiple reviewers. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Extracted data were synthesized narratively to integrate qualitative and quantitative findings. Results: The search yielded 1826 records; after removing duplicates and applying eligibility criteria, 12 studies were included in the final synthesis. Considerable heterogeneity in design and outcomes was observed. Most included studies reported improvements in students’ knowledge, self-efficacy, and reflective capacity, alongside high levels of acceptability. Conclusions: Digital and technology-enhanced learning appears feasible and acceptable for palliative care education; however, the current evidence base is limited by methodological heterogeneity, reliance on self-reported outcomes, and predominantly short-term evaluations. Further rigorous, large-scale studies with objective outcome measures are required to determine sustained educational and practice impact. Full article

This narrative review examines how immersive virtual and mixed-reality (VR/MR) technologies, combined with AI-driven virtual agents, can support the prevention and long-term management of chronic illness. Chronic diseases represent a significant global health burden, and conventional care models often struggle to sustain patient engagement, motivation, and adherence over time. To address this gap, we conducted a narrative review of reviews and meta-analyses. We selected empirical studies published between 2020 and 2025, identified through searches in PubMed, Web of Science, and Google Scholar. The aim was to capture the state of the art in the integrated use of VR/MR and AI in chronic illness care, and to identify key opportunities, challenges, and considerations relevant to clinical practice. The reviewed evidence indicates that VR/MR interventions consistently enhance engagement, motivation, symptom coping, and emotional well-being, particularly in rehabilitation, pain management, and psychoeducation. At the same time, AI-driven conversational agents and virtual therapists add adaptive feedback, personalization, real-time monitoring, and continuity of care between clinical visits. However, persistent challenges are also reported, including technical limitations such as latency and system dependence, ethical concerns related to data privacy and algorithmic bias, as well as psychosocial risks such as emotional overattachment or discomfort arising from avatar design. Overall, the findings suggest that the most significant clinical value emerges when VR/MR and AI are deployed together rather than in isolation. When implemented with patient-centered design, clinician oversight, and transparent governance, these technologies can meaningfully support more engaging, personalized, and sustainable chronic illness management. Full article

Irritable Bowel Syndrome (IBS) affects 4–15% of the global population, and the limited efficacy of existing pharmacologic therapies has driven growing interest in plant-based therapeutic options among both patients and clinicians. A comprehensive assessment of all plant extracts investigated in IBS is therefore essential, given the limited effectiveness of conventional treatments and the increasing interest in complementary approaches. Evidence from recent systematic reviews and meta-analyses consistently indicates that peppermint oil is the most effective botanical agent, particularly for reducing abdominal pain and overall IBS symptom severity. Iberogast (STW-5 and STW-5 II) has also demonstrated clinical improvements across multiple trials, while curcumin shows mechanistic and preliminary clinical potential by modulating several IBS-related pathways. In contrast, extracts such as Curcuma xanthorrhiza, Fumaria officinalis, and various Ayurvedic formulations have not shown significant clinical benefit. Other agents, including Aloe vera, flavonoids, St John’s wort, and ginger, exhibit mixed or inconsistent results, reflecting heterogeneity in study designs and underlying mechanisms. A review of international guidelines reveals that peppermint oil is the only plant-based therapy consistently acknowledged across adult and pediatric recommendations. The aim of this review is to summarize, compare, and critically evaluate all plant extracts studied for the prevention and treatment of IBS, integrating mechanistic pathways, clinical evidence, and current international guideline recommendations to clarify their therapeutic relevance for clinical practice. Full article

Grassland-based livestock systems across Mexico’s arid and semi-arid belt are increasingly exposed to drought, degrading forage reliability, and soil function. This review synthesizes evidence on native C4 grasses and forage shrubs as complementary building blocks of drought-resilient swards. We searched Web of Science, Scopus, CAB Abstracts and key grey sources (USDA/NRCS Plant Guides, USFS FEIS, Tropical Forages, SNICS) for 1990–2025 studies in English/Spanish. Dominant native grasses (Bouteloua spp., Hilaria belangeri, Digitaria californica, Trichloris crinita, Sporobolus airoides, Panicum hallii) provide high warm-season digestibility and structural cover via C4 physiology, basal/intercalary meristems, and deep/fibrous roots. Forage shrubs (Atriplex canescens, Desmanthus bicornutus, Leucaena leucocephala, Flourensia cernua, Prosopis spp.) bridge the dry-season protein/energy gap and create “resource islands” that enhance infiltration, provided anti-nutritional risks (mimosine/DHP, tannins, salts/oxalates, terpenoids) are managed by dose and diet mixing. We integrate these findings into a Resistance–Recovery–Persistence framework and translate them into operations: (i) site-matching rules for species/layouts, (ii) PLS (pure live seed)-based seed specifications and establishment protocols, (iii) grazing TIDD (timing–intensity–distribution–duration) with a practical monitoring dashboard (CP targets, stubble/cover thresholds, NDVI/SPEI triggers). Remaining bottlenecks are seed quality/availability and uneven extension; policy alignment on PLS procurement and regional seed increase can accelerate adoption. Mixed native grass–shrub systems are a viable, scalable pathway to strengthening drought resilience in Mexican rangelands. Full article

Background/Objectives: Home care plays a crucial role in contemporary healthcare systems, particularly in the long-term care of people with chronic and progressive illnesses. Family caregivers often experience substantial physical, emotional, and organizational burden. Telemedicine and digital health applications have the potential to support home care by improving health monitoring, communication, and care coordination. However, their use among family caregivers remains inconsistent, and little is known about how organizational support structures such as telemedicine centers influence acceptance and everyday use. This study aims to examine the benefits of telemedicine in home care and to evaluate the role of telemedicine centers as supportive infrastructures for family caregivers. Methods: A mixed-methods design was applied. Quantitative data were collected through an online survey of 58 family caregivers to assess the use of telemedicine and digital health applications, perceived benefits, barriers, and support needs. This was complemented by an in-depth qualitative case study exploring everyday caregiving experiences with telemedicine technologies and telemedicine center support. A systematic literature review informed the theoretical framework and the development of the empirical instruments. Results: Most respondents reported not using telemedicine or digital health applications in home care. Among users, telemedicine was associated with perceived improvements in quality of care, particularly through enhanced health monitoring, improved communication with healthcare professionals, and increased feelings of safety and control. Key barriers to adoption included technical complexity, data protection concerns, and limited digital literacy. Both quantitative findings and the qualitative case study highlighted the importance of structured support. Telemedicine centers were perceived as highly beneficial, providing technical assistance, training, coordination, and ongoing guidance that facilitated technology acceptance and sustained use. Conclusions: Telemedicine and digital health applications can meaningfully support home care and reduce caregiver burden when they are embedded in supportive socio-technical structures. Telemedicine centers can function as central points of contact that enhance usability, trust, and continuity of care. The findings suggest that successful implementation of telemedicine in home care requires not only technological solutions but also accessible organizational support and targeted training for family caregivers. Full article

Canine systemic aspergillosis is a rare but highly serious condition, often associated with a fatal outcome. This review encompasses all reported cases of canine systemic aspergillosis from 1978 to the present, focusing exclusively on studies in which the diagnosis was confirmed through fungal culture. A total of 155 clinical cases reported in the literature were included. Among these, the German Shepherd was the most frequently affected breed (65.16%), followed by mixed-breed dogs (7.74%). The predominant Aspergillus species isolated was A. terreus (57.69%), although other species were also reported, including A. deflectus, A. fumigatus, A. niger, A. caninus, A. versicolor, A. alabamensis, A. citrinoterreus, and A. floccosus. Recognizing clinical signs and accurately interpreting laboratory findings are crucial for early diagnosis and timely intervention, both of which can potentially improve outcomes. This review provides a detailed discussion of these aspects. Full article

The gut microbiota represents a complex microbial ecosystem with the potential to influence athletic performance, energy metabolism, inflammatory responses, and recovery capacity in athletes. However, the specific relationship between microbiota and performance in combat sport athletes remains poorly characterized. This scoping review systematically maps current evidence on gut microbiota-combat sports performance relationships, identifies microbial response patterns to training and competition, evaluates nutritional prebiotic and probiotic interventions, and highlights methodological gaps to guide future research. Following the PRISMA-ScR framework, 8 studies were identified, which included 247 elite and high-level athletes, comprising 169 males and 78 females, with sample sizes ranging from 12 to 53 across wrestling, mixed martial arts, martial arts, judo, and taekwondo. Associations were observed between gut microbiota characteristics and training intensity, competition level, weight management, and pre-competition psychological states. Limited taxonomic consistency was observed across studies, with most bacterial genera appearing in a single investigation, precluding the identification of robust sport-specific microbial signatures. Preliminary trials demonstrated improvements in gastrointestinal symptoms, aerobic performance, and psychological fatigue with prebiotic and probiotic interventions. However, small sample sizes and methodological heterogeneity across studies limit generalizability and preclude definitive conclusions regarding the role of gut microbiome in combat sports performance. Full article

The rapid commercialization of next-generation photovoltaic (PV) technologies, particularly perovskite, thin-film roll-to-roll (R2R) architectures, and tandem devices, requires robust assessment of environmental performance at the level of industrial manufacturing processes. Environmental impacts can no longer be evaluated solely at the device or module level. Although many life-cycle assessment (LCA) studies compare silicon, cadmium telluride (CdTe), copper indium gallium selenide (CIGS), and perovskite technologies, most rely on aggregated indicators and database-level inventories. Few studies systematically compile and harmonize process-level life-cycle inventories (LCIs) for the manufacturing steps that differentiate emerging industrial routes, such as solution coating, R2R processing, atomic layer deposition, low-temperature annealing, and advanced encapsulation–metallization strategies. In addition, inconsistencies in functional units, system boundaries, electricity-mix assumptions, and scale-up modeling continue to limit meaningful cross-study comparison. To address these gaps, this review (i) compiles and critically analyzes process-resolved LCIs for innovative PV manufacturing routes across laboratory, pilot, and industrial scales; (ii) quantifies sensitivity to scale-up, yield, throughput, and electricity carbon intensity; and (iii) proposes standardized methodological rules and open-access LCI templates to improve reproducibility, comparability, and integration with techno-economic and prospective LCA models. The review also synthesizes current evidence on recycling, circularity, and critical-material management. It highlights that end-of-life (EoL) benefits for emerging PV technologies are highly conditional and remain less mature than for crystalline-silicon systems. By shifting the analytical focus from technology class to manufacturing process and life-cycle configuration, this work provides a harmonized evidence base to support scalable, circular, and low-carbon industrial pathways for next-generation PV technologies. Full article